Kowhai Midwives

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Healthy babies start with healthy pregnancies.

THE START OF AN AMAZING JOURNEY!

Welcome to the wonderful world of pregnancy! Hold on tight cause this is going to be a ride like no other you've had before!
You might already be experiencing some symptoms of pregnancy or you might be lucky enough to be sailing through without so much as a sniff of nausea! You are learning already that pregnancy and how it is experienced is unique for every person. Discovering how to manage a lot of the "normal" symptoms and self-caring are vitally important. The biggest thing you can do at this stage is be kind to yourself! Listen to your body: sleep and rest when you need to, eat what your body tells you it is hungry for, drink as much water as possible, snack regularly through the day if nausea is getting to you. I talk a lot about the major role hormones play in pregnancy and this first trimester is one of the times you notice the effects the most.
Please take the time to read through the info below: refer back to it later if you need to. If you have serious concerns about yours or your baby's well-being please contact your midwife or GP.

Antenatal screening for Down syndrome and other conditions provides a risk estimate for Down syndrome (trisomy 21), trisomy 18 (Edwards syndrome), trisomy 13 (Patau syndrome) and some other rare genetic disorders.
This is entirely your choice if you wish to do this screening or wish to decline. 1st trimester screening involves a blood test & ultrasound. This is screening only- if your result comes back saying you have a higher chance then you will be offered more invasive diagnostic testing.
Some of the things that you may want to consider:
What will you do with this info? Would you want to know? Would you wish to terminate the pregnancy? Would you wish to continue with the pregnancy but still know? Would you rather not know either way? Will it change the way you feel about this pregnancy? If you have a high chance screening result, will you want to do the more invasive testing (which carries significant risk to the pregnancy)?
Remember- there is no right or wrong answer... only what is right for you and your whanau.click here to view the MoH antenatal screening for Down Syndrome booklet....

Being sensible rather than being paranoid is the best way to make a choice around what you should be eating, and remember that as with anything to do with your pregnancy, ultimately the choice will be yours to make. I would, however, recommend that you avoid raw eggs, undercooked meat, unpasteurised dairy products, raw shellfish, and to wash all your vegetables well before consumption. The general rule of thumb is “ if in doubt- leave it out!”.click here to open the Food Safety in Pregnancy guide....

The MoH recommends that you take 0.8mg of folic acid one month before conception until the end of week 12 to reduce, though not entirely prevent, the risk of Neural Tube Defects such as spina bifida. If you wish to research an alternative to folic acid, try searching for and reading about folate supplements.

The MoH also recommends taking 150mcg of iodine throughout pregnancy and to continue while you breast feed to support normal brain development for your baby.
Your midwife or GP can give you a prescription for these supplements or you can buy these at a low cost direct at your local pharmacy. If you are taking a pregnancy multi, check the back panel to see if they contain the recommended amounts of folic & iodine.
Any other non prescribed supplements that you take in your pregnancy should be discussed with a pharmacist, GP, Midwife or qualified Naturopath. Remember that with any recommendation in your pregnancy the choice to take supplements is entirely yours.

The simple answer is no. The current screening that is on offer to pregnant women is that you can screen in the first trimester for Down Syndrome (Trisomy 21), Edwards Syndrome (Trisomy 18), and Patau Syndrome (Trisomy 13) with a combined Maternal Serum Screen (Mss1) and Nuchal Translucency Ultrasound scan where results are combined with your age and a risk ratio is reported. There is also a second trimester screen for Neural Tube defects(Mss2) available. The current funding is for either the first trimester screen or the second trimester screen, not both. Remember-this is a screen only- not a diagnostic test. Diagnostic results are obtained by an invasive procedure where either amniotic fluid is removed from around the baby or a small part of the placenta or cord tissue is retrieved, and these procedures come with an increased risk of miscarriage. Talk to your midwife or other healthcare professional about making an informed choice to participate or decline antenatal screening.

In pregnancy it is normal to have an increased appetite, however this not an excuse to eat junk food for two!
In its simplest form you should aim to reduce your sugar intake as much as possible, eat REAL food over processed food, load your diet up on veges- especially colourful ones, eat some healthy dairy products, some good sources of protein (meat, eggs, nuts etc), and healthy fats (avocado, coconut etc). Aim for balance and nutrition, make good choices most of the time and keep treats as treats.

If you are in a healthy weight range an average of 7-14 kg would not be unrealistic however each woman varies and as long as weight gain is not excessive it is normally not an issue. Huge weight gain is not a good idea in pregnancy.

If you have a high BMI where you are classed as obese or morbidly obese pre pregnancy, you should aim for as little weight gain as possible- in other words reducing your saturated fats, and high GI carbohydrates and high sugar foods, and increase your exercise while pregnant. Most pregnancy issues are complicated by obesity, and morbid obesity makes your pregnancy high risk during labour, birth and the postpartum period.

REMEMBER that most of your weight gain will occur in the last trimester (from 28 weeks til birth) so aim to keep your weight gain down in the earlier months.

Excessive weight gain and obesity can cause major complications in pregnancy & birth.

We don’t like to make anyone feel uncomfortable about their weight but these are conversations we have to have (just like with smoking) as it does have a direct impact on the health of your pregnancy and baby. Keeping your weight gain under control in pregnancy will also mean you have less weight to lose after you have baby and will recover faster.

The best thing that you could do for your baby is to become smoke-free. It would be fantastic if you were smoke-free before becoming pregnant, but it is never too late to quit smoking at any stage. This is a fantastic time to make the change for you & for baby.

I can provide you with nicotine replacement patches and gum etc or you can call or text the quit line.

Pregnant women can feel very guilty that they drank alcohol before they knew they were pregnant. Once you have your pregnancy confirmed, you are then informed to make a choice whether to drink alcohol or not. When you are pregnant, every time you drink alcohol (e.g. beer, wine, spirits or ready-to-drink beverages), your baby is drinking the alcohol too. All alcohol is carried by your bloodstream, through the placenta, to your baby.
Your unborn baby has no protection from the alcohol you drink. As your midwife, I would recommend that you follow the NZCOM consensus statement around alcohol in pregnancy and avoid any amount of alcohol:"There is no known safe level of alcohol consumption during pregnancy. Therefore parents planning a pregnancy and women who are pregnant should be advised not to drink alcohol."

We are pretty big on consumer rights in NZ and healthcare is no different. We are priviledged in NZ to have The Code of Health and Disability Services Consumers' Rights (the Code) which establishes the rights of health consumers, and the obligations and duties of providers to comply with the Code. It is a regulation under the Health and Disability Commissioner Act. As health professionals, midwives are bound by this code.

As a midwife I routinely offer 3 scans- an early dating scan to confirm your estimated due date if you are unsure of your dates, a 12 week nuchal translucency scan to go with your Mss1 screening for Down Syndrome, & a 20 week anatomy scan to for check for anything unusual about your baby’s body.

Beyond that I will only offer more scans if I think they are medically indicated.

You DO NOT have to have scans: you can have all of them, some of them or none of them... it is your body and your choice! I am very open to discussions and will support you in whatever you choose.

There are some ultrasound businesses that offer additional scans that you need to pay for such as 4D. I would encourage you to think carefully about these extra scans as they are not medically indicated and use more powerful ultrasound and for a longer period. Ultrasound is known to heat tissues slightly and you can see babies move in response to ultrasound. The long-term consequences of these effects are still unknown. click here for FDA info on ultrasounds....